Jackson syndrome (brain stem syndrome)

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Classification according to ICD-10
G46.3 Brain stem syndrome
ICD-10 online (WHO version 2019)

The Jackson syndrome , also ventral medulla para median syndrome or Jackson's palsy , is a very rare symptom complex in Neurology , by a lesion in the brainstem associated with the medulla oblongata caused the medulla oblangata. Paralysis of the tongue ( hypoglossal palsy ) occurs on the same side of the lesion and hemiparesis ( hemiparesis ) on the opposite side of the lesion. Jackson syndrome belongs to the group of alternating brain stem syndromes .

Cause and clinical features

Jackson syndrome is caused by a lesion in the lower or caudal medial medulla oblongata. The lesions are ischemic lacunar brain stem lesions. They arise from local microangiopathic changes or embolic occlusions of the end sections of the vertebral artery ( arteria vertebralis ). Some authors also refer to the location as ventromedial or ventral paramedian (front and center). The disease is characterized by the appearance of ipsilateral paralysis of the tongue, which is caused by damage to the nucleus nervi hypoglossi located in the medial medulla oblangata . On the contralateral side, i.e. on the opposite side of the lesion, hemiplegia occurs due to damage to the pyramidal tract above the pyramidal trajectory crossing . The nerve fibers of the pyramidal tract cross only further caudally in the pyramidal tract junction on the opposite side.

Demarcation

In addition to Jackson syndrome, there is another, more common brainstem syndrome with a lesion in the area of ​​the medial medulla oblongata. It is known as Dejerine-Spiller syndrome . Jackson syndrome is a reduced variant of Dejerine-Spiller syndrome. In addition to ipsilateral tongue palsy and contralateral hemiparesis, Dejerine-Spiller syndrome also has a contralateral sensitivity disturbance with preserved pain and temperature sensation due to a lesion of the posterior cord tract .

Medical history

The name goes back to the first description of the symptom complex by the English neurologist John Hughlings Jackson (1835-1911) in 1872. He described a 51-year-old patient with ipsilateral hypoglossal palsy and contralateral hemiparesis. The pathological examination showed bleeding in the area of ​​the medial medulla oblongata.

Individual evidence

  1. ↑ Johannes Lang, Werner Wachsmuth , Titus von Lanz : Practical Anatomy. Volume 1, Springer, 1979, ISBN 3-540-13536-7 , p. 510.
  2. ↑ Peter Reuter: Springer Lexicon Medicine. Springer, Berlin a. a. 2004, ISBN 3-540-20412-1 , p. 1071.
  3. ^ A b E. Evangelidou, R. Dengler: Acute brain stem syndrome. In: The neurologist. 80, 2009, pp. 975-986, doi: 10.1007 / s00115-008-2608-x .
  4. ↑ a b c d M. Krasnianski u. a .: Classic alternating medulla oblongata syndromes. In: Advances in Neurology - Psychiatry. 71, 2003, pp. 397-405, doi: 10.1055 / s-2003-41192 .
  5. ↑ Peter Berlit: Clinical Neurology. Springer, 2011, ISBN 978-3-642-16919-9 , p. 1076.
  6. ↑ Jochen Fanghänel, Anton Johannes Waldeyer: Anatomie des Menschen. de Gruyter, 2003, ISBN 3-11-016561-9 , p. 423.
  7. ↑ Alexander Hartmann: The stroke. Pathogenesis, clinical features, diagnosis and therapy of acute cerebrovascular diseases. Steinkopff-Verlag, Darmstadt 2001, ISBN 3-7985-1211-6 , p. 283.
  8. ↑ H. Jackson, Case of paralysis of the tongue from haemorrhage in the medulla oblongata. In: The Lancet . 1872; 2, pp. 770-773.